NPI | 1235405473 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019.029310) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 319.018450) |
Enumeration Date | 2012-03-30 |
Last Update Date | 2017-08-16 |